HRT for Breast Cancer Survivors

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What is the current information regarding estrogen replacement therapy for former breast cancer patients? I am now in menopause and am affected [by it] both physically and emotionally. I was treated 12 years ago with radiation and chemotherapy for breast cancer with borderline estrogen receptor-positivity.

Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

Although hormonal replacement therapy is generally discouraged in breast cancer survivors, it should still be considered in patients whose menopausal symptoms warrant intervention. In other words, one should not rule out the use of HRT just based on a history of breast cancer alone, especially if the initial tumor was estrogen receptor-negative. If you are having both emotional and physical effects from menopause, then you might have significant improvement in quality of life from the use of HRT. This is an individual decision that you should make after discussing the potential risks and benefits you're your doctor(s). Simply stated, HRT is considered potentially dangerous in breast cancer survivors, but should not be withheld universally in this population.

Mar 21, 2013 - Evidence does not definitively link the decline in the use of hormone replacement therapy (HRT) to a fall in the incidence of breast cancer, according to the last in a series of critiques published in the April issue of the Journal of Family Planning & Reproductive Health Care.